Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail: info@tmi.tolani.edu, Web: www.tolani.edu
(New Admission Diploma in Nautical Science 2021)


Application Summary: Diploma in Nautical Science
 
Dossier ID: DNS2176953 Name: Abhay Pratap Singh Chauhan
  Address: 108, Block II Arya Nagar, Rajpur Road
Telephone No.: Mobile no: 8169588016
E-mail: abhay.chauhan503@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 200 (Includes Convenience fee of ₹ ) DD Number: -
Issuing Bank: - Transaction Id: 427817747
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2176953 are true and correct.
Signature of Candidate Signature of Parent/Guardian
   
   

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Date ________________ Date ________________
 
Please quote your dossier id and full name for any future correspondence
Please keep a copy of the form for your reference for communicating with the Institute

Note: Please remember to login and fill in your 12th std PCM marks when they are published & IMUCET Application number in order to complete your application form.

Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail: info@tmi.tolani.edu, Web: www.tolani.edu
(New Admission Diploma in Nautical Science )

APPLICATION FOR ADMISSION - 2021

 
  Dossier ID: DNS2176953
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: Abhay Pratap Singh Chauhan
Mother's Name: Poonam Chauhan
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 11 Oct 2003 Nationality: Indian
Place of Birth: Dehradun Personal Identification Mark: Mole on right side of neck
Blood Group: O + Address for Communication: 108, Block II Arya Nagar, Rajpur Road
State: Uttaranchal Country: India
Pin: 248001 City/District: Dehradun
Mobile no: 8169588016 Telephone No. with STD code:
Aadhar Card No:706512005310 E-mail: abhay.chauhan503@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: Kuldeep Singh Chauhan Relationship with candidate: Father
Parents Date of Birth: 08 Aug 1970 Parent's/Guardian's Occupation/Designation: Private Job
   
Office Address:
   
Address: Ocean Network Express India Pvt Ltd 3rd Floor, A-Wing, Fulcrum, Hiranandani Business Park, Sahar Road, Andheri East
Country: India State: Maharashtra
City/District: Mumbai Pin: 400099
Tel: Mobile no.: 8291208988
Fax: Email: kuldeepchhn@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2019 Year of Passing: 2021
Board: CBSE Board: CBSE
School: R.N.Podar School School: Doon Heritage School
City: Mumbai City: Dehradun
English %: 93 Board Roll No./Seat No.:
Aggregate Percentage: 92 School/College Code:
  Centre code:
  Address of School/College: Doon Heritage School, Baronwala, Uttarakhand
  Pin: 248007
  Contact Nos: 7500299456
  Email: doonheritageschool@gmail.com
  Aggregate Percentage:
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100
Chemistry 100
Mathematics 100
Physics, Chemistry & Mathematics combined Percentage:
English 100
   
IMU CET Application Number:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: Studying and preparing for IMUCET
Why do you wish to join TMI?: Best institute for DNS program with very high rate of placement after course
What are your hobbies?: Photography
What are your strengths?: Leadership Qualities and Hardworking
What are your weaknesses?: Time Management
How do you intend to meet the expenses of this program?: Own Resources
 
Review you documents:
Birth certificate DGS Approved Medical Fitness Certificate not uploaded Class X marksheet School leaving certificate not uploaded Class XII admit card not uploaded Class XII marksheet not uploaded
 
Declaration

I hereby declare that all the statements made above are true and correct.

Signature of Candidate

 

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Date ________________

 
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